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All elderly are fragile, but some are more fragile than others: an epidemiological study from one of the busiest trauma centers in Italy

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Abstract

As the older population increases, the number of elderly accessing the emergency department following a trauma increases accordingly. High-level trauma enters together with the identification of predictive parameters for poor outcome and mortality, may result in a death rate improvement of up to 30% in this group of patients. This study analyzes the epidemiology of major trauma admissions at Niguarda Trauma Center in Milan, Italy, focusing on the geriatric population and aiming to discriminate the trauma outcomes in the range of population between 65 and 75 years old (Senior Adult) and to compare it with the outcomes among people over 75 years old (Elderly). The variables analyzed included mortality, mechanism of injury, body district injured, Injury Severity Score (ISS), Trauma Injury Severity Score (TRISS), Geriatric Trauma Score (GTO), and outcome. Head trauma remains the main cause of mortality with falls and road accidents being the most common mechanism of injury. Frailty and associated use of anticoagulant and antiplatelet therapy increased the risk of death by 42%. The subdivision of the elder patients into two groups (65–75 and > 75) showed a difference in the probability of death and effective mortality rate.

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Authors and Affiliations

  1. Chirurgia Generale Trauma Team, Ospedale Niguarda, Milan, Italy

    Virdis Francesco, Bini Roberto, Cannavale Giulia, Cioffi Stefano Piero, Altomare Michele, Spota Andrea, Chiara Osvaldo & Cimbanassi Stefania

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  1. Virdis Francesco
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  2. Bini Roberto
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  3. Cannavale Giulia
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  4. Cioffi Stefano Piero
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  5. Altomare Michele
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  6. Spota Andrea
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  7. Chiara Osvaldo
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  8. Cimbanassi Stefania
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by GC. The first draft of the manuscript was written by FV and RB. CSP, AM, SA, CO, and CS: reviewed and commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Virdis Francesco.

Ethics declarations

• The authors did not receive support from any organization for the submitted work. • No funding was received to assist with the preparation of this manuscript.

• No funding was received for conducting this study.

• No funds, grants, or other support were received.

• The authors have no relevant financial or non-financial interests to disclose.

• The authors have no competing interests to declare that are relevant to the content of this article.

• All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article

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Francesco, V., Roberto, B., Giulia, C. et al. All elderly are fragile, but some are more fragile than others: an epidemiological study from one of the busiest trauma centers in Italy. Updates Surg 74, 1977–1983 (2022). https://doi.org/10.1007/s13304-022-01337-y

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